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Prognostic value of peak work rate indexed by left ventricular diameter
Charlotte Eklund Gustafsson1, Magnus Ekström2, Martin Ugander3,4
1Department of Clinical Physiology, Research and Development, Växjö Central Hospital, Region Kronoberg, Växjö, Sweden.
Scientific Reports
|May 31, 2023
Summary
Peak work rate indexed to left ventricular diameter (Wpeak/LVEDD) shows prognostic value for cardiovascular mortality. A low Wpeak/LVEDD combined with low peak work rate indicates a particularly poor prognosis.
Area of Science:
- Cardiology
- Exercise Physiology
- Clinical Prognostics
Background:
- Left ventricular diameter (LVEDD) increases with training and cardiac disease.
- High exercise capacity is linked to better health outcomes.
- Prognostic markers for cardiovascular events are crucial.
Purpose of the Study:
- To assess if peak work rate indexed to LVEDD (Wpeak/LVEDDrest) predicts cardiovascular mortality.
- To evaluate the prognostic information carried by Wpeak/LVEDDrest.
Main Methods:
- Calculated Wpeak/LVEDDrest in 3083 patients undergoing exercise tests and echocardiography.
- Defined low Wpeak/LVEDDrest based on sex- and age-specific 5th percentiles.
- Used Cox regression to analyze the association with cardiovascular mortality.
Main Results:
- Wpeak/LVEDDrest was significantly associated with cardiovascular mortality (HR 0.28).
- Its prognostic strength was comparable to Wpeak (% predicted) when adjusted for age and sex.
- A combination of low Wpeak/LVEDDrest and low Wpeak indicated a particularly poor prognosis (HR 6.4).
Conclusions:
- Wpeak/LVEDDrest is a valuable prognostic indicator for cardiovascular mortality.
- It does not offer incremental value over Wpeak alone.
- The combination of low Wpeak/LVEDDrest and low Wpeak identifies high-risk patients.
